July 31, 2008

Flu shots may not protect the elderly

The flu vaccine might not protect seniors as much as previously thought, according to a study of more than 3,500 patients over age 65 that found no link between flu vaccination and risk of pneumonia during three flu seasons.

One problem with previous studies looking at efficacy is that they failed to account for differences between healthier seniors and those who were 'frail,'" said lead researcher Michael Jackson, a postdoctoral fellow at the Group Health Center for Health Studies.

This study, published in The Lancet, used a rigorous case control method that included a control time period, after a flu vaccine became available but before each flu season actually started.

During those pre-flu season periods, people who had been vaccinated were much less likely to get pneumonia. Why?

One possibility is the "healthy user" effect.

"Those who got the vaccine happened to be healthier--not because the flu vaccine was protecting them from pneumonia caused by the flu, since it wasn't present yet," Jackson said.

It's not the first study to point out that the use of flu vaccines in seniors might be a waste of time and money. A review by George Washington University researchers published in the Lancet Infectious Diseases found that flu shots may not save as many older patient's lives as generally claimed.

And a study led by Dean Eurich of the University of Alberta found that flu vaccinated people fared better than those without vaccination during the part of the year when influenza wasn't circulating. Once they adjusted for the "healthy user" effect, however, they found the benefit close to disappeared.

"So for several years now, we have had large studies which question the benefit of influenza vaccination. The notion that flu shots are so important thus seems more the result of repeated assertion than the weight of solid scientific evidence," said Peter Doshi, a graduate student at MIT, who was not involved in the Lancet study.

One of Doshi's studies, published in the May issue of the American Journal of Public Health, questioned the impact of influenza itself. Doshi suggests influenza is not as much of a problem as we have thought. Deaths from influenza have been consistently declining over the twentieth century, a trend that began far before the introduction of widespread vaccination, Doshi asserts.

Still, the researchers say the flu vaccine is safe so it seems worth getting, even if it might lower the risk of pneumonia only slightly.

"Despite our findings, and even though immune responses are known to decline with age, I still want my grandmother to keep getting the flu vaccine," said Jackson.

Doshi finds this troubling because it suggests there is an unspoken rule that "responsible scientists" must encourage vaccination, never question, discourage, or remain neutral, no matter what the evidence is.

"Such a taboo is irresponsible and definitely not serving the public's best interest," he said.

It also throws us back to the 1950s, the era of "the drug is safe, therefore let's use it," Doshi said. In 1962 the Food and Drug Administration required that drug manufacturers had to prove the effectiveness of their products before marketing them.

Comments

It would be interesting if any actuary at BCBS, Humana or State Farm etc had the stats for the following:
1. How many people get sick or injured just going to get the shot.
2. What effect a plain old COQ10 200MG taken regulary has instead of the shot (or Emergen-C) etc.
3. A diet with regular fiber, fruit and veggies.
4. Regular garlic eaters etc.

Have not had a flu shot.....EVER! Don't even know the last time I had the flu.

A different outcome should be looked at also. What is severity of illness? requiring hospital, requiring ICU, length of illness. I am not interested in the politics of getting vaccination or not. If it does work does it improve people's lives.

The drug industry has changed the conversation about drugs leading to an over usage, but do not confuse that issue with one of effectiveness.

As far as testimonials, I had the flu once when not getting the shot and none when getting. I have not drawn a conclusion on its effectiveness in me.

Chicago Joe, your argument No. 1 is a bit fallacious. In order for that to be a valid consideration, you would have to assume that if the person were not going to get a flu shot that they would otherwise be home in bed or doing something else that's very minimally risky. But generally speaking, if the person didn't go get a flu shot, they would probably go to the mall or just out for a walk or some other activity which might risk illness or injury.

That said, I think you're other points are valid. I'm not anti-vaccine in general, but I am anti-flu vaccine. I just don't think the risk of getting the flu outweighs other factors, and I think the best flu protection is simply taking care of oneself. Plus, despite what they say, I think there are side effects. My mother used to make me get the flu shot and, sure enough, I'd get the flu. I haven't had a flu shot since I was on my own except for two years ago when I was pregnant and I allowed my doctor to talk me into getting it. Again, sure enough, after years without getting the flu, guess what happened?

Every year we hear that either (a) they ran out of the vaccine and most people weren't able to get the shot who wanted it and/or (b) the particular strains that they vaccinated against weren't the particular strains that were prevalent that season. In either case, cases of the flu have not increased and have often decreased. That info, combined with this current study, seems to show pretty strongly that the vaccine isn't all it's cracked up to be.

Because Grandpa needs 25 mcg of mercury in his brain so that the pharma companies can make their money on the flu shots AND develop and sell dementia drugs to "treat" the mercury poisoning? Just tossing the ball toward the hoop on that one.....

first for Harold, 25 mics of mercury is way over the recommendations by the FDA or CDC. The flu shot is 50,000 parts per billion mercury. 2 ppb is U.S. EPA limit for drinking water, 200 ppb mercury in liquid is the level the EPA classifies as hazardous waste.

And for Miles, it is nearly impossible to compare the 1918 flu pandemic to a pandemic today. In 1918 there was no sanitation, no antibiotics, Doctors did not think it was important to wash their hands.

NJ has even mandated the flu shot for children over 6 months of age. The vaccine insert says it has not been proven safe or effective for children under the age of 2. So why the push to vaccinate, it is a huge money maker for the manufacturers. Doctors and Pharmaceutical companies have no liability for vaccines. All claims must go through the National Vaccine Injury Compensation Program.

I, unfortunately, know the dangers of the flu vaccine. I had a "not uncommon" reaction which left me with permanent physical and neurological damage. So when researchers say it is so safe it is worth the risk, I would disagree.

It's misleading to apply the EPA hg limit for drinking water to vaccines. Drinking water standards are measured in ppb because we drink lots of water everyday. What matters is the actual amount of mercury that is ingested, not the ppb concentration. Think about it. If you inject kid A with 1 microgram of ethyl mercury along with 1 microgram of sterile water, the ppb concentration would be a whopping 500 million ppb. But if you inject kid B with 10 mics of ethyl hg along with one million mics ( 1/10 of a gram) of sterile water, the ppb would be 10,000 ppb. I know it's easier to scare the parents of kid A, but the fact is, he's getting less hg than kid B.

And doctors did know enough to wash their hands in 1918. The germ theory of disease was 30 years old by then, and I don't know where you get the idea that the United States had "no sanitation" in 1918. Miles is more fact-based than you are prepared to give him credit for.